2020–2021 BCSC Basic and Clinical Science Course™
8 External Disease and Cornea
Chapter 6: Clinical Approach to Depositions and Degenerations of the Conjunctiva, Cornea, and Sclera
Degenerations of the Conjunctiva
A pinguecula is a common conjunctival condition that occurs typically on the nasal side of the bulbar conjunctiva, adjacent to the limbus in the interpalpebral zone. It is usually bilateral, appears as a yellow-white elevated mass (Fig 6-1), and occurs as a result of the effects of aging, UV light exposure, and environmental insults such as dust and wind. Pingueculae represent an elastotic degeneration (the material stains for elastin but is not broken down by elastase) of subepithelial collagen with hyalinized connective tissue. The mass may enlarge gradually over long periods of time. There may be recurrent inflammation and ocular irritation. Lubricant therapy to alleviate ocular irritation is the mainstay of treatment. Excision is indicated only when pingueculae are cosmetically unacceptable, when they become chronically inflamed, or when they interfere with contact lens wear. Judicious use of topical corticosteroids may be considered for patients with inflammation, but their use as longterm therapy for pingueculae is strongly discouraged because of their adverse effects.
Excerpted from BCSC 2020-2021 series: Section 10 - Glaucoma. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.